ICGP conference: A number of the former health boards had been taking childcare costs into account in recent years when assessing people's eligibility for medical cards, Minister for Health Mary Harney said at the weekend.
She said she only became aware of this in recent months and in a move to make the system more equitable for all, childcare costs would now be taken into account when all applicants for medical cards, including the new doctor-only medical cards, were being assessed.
Despite the fact that GPs have still not agreed to co-operate with the introduction of the new cards, Ms Harney said advertisements would be placed in newspapers this week seeking applicants for them.
Talks will also take place between the Health Service Executive Employers' Agency and the Irish Medical Organisation this week under the auspices of the Labour Relations Commission on the planned introduction of the 200,000 new cards and a number of other issues concerning GPs, including money they say is owed to them over a number of years. The talks begin tomorrow and the GPs have been warned they will not get the pay rises unless they agree to the introduction of the cards.
Meanwhile speaking at the annual conference of the Irish College of General Practitioners (ICGP) in Galway at the weekend Ms Harney said she was surprised to learn 70,000 people "have medical cards based on hardship for a whole host of political" reasons.
As delegates cheered at her slip of the tongue she continued: "or for a whole host of personal or family reasons".
Under new medical card guidelines to be published shortly there would be more uniformity in how they were handed out, she said.
She also disclosed that there was insufficient money to implement all the strategies and reports compiled for the Department of Health. These included the primary care strategy. To implement them all would cost an estimated €50 billion, she said.
Amid calls from the GPs to tackle the manpower crisis in general practise, with a shortage of GPs in some inner city and rural areas, she confirmed there would need to be changes in the current system of medical education, that more Irish students would have to be trained and over-reliance on foreign doctors would have to be addressed. She said she strongly supported proposals to have a graduate entry system for some medical education.
Dr Philip Crowley, director of the ICGP's health inequalities in general practice project, called for a special payment to encourage GPs to work in deprived areas. He said while there were positive things about working in a poor community, a survey he conducted among over 700 GPs found lack of access to hospital and community services for patients was regarded by 59 per cent of them as one of the major difficulties in providing quality care in deprived areas.
"The amount of your day you spend ringing hospitals to see can somebody be seen quicker or trying to contact somebody to overcome obstacles to public patients accessing services is criminal," he said.
Ms Harney agreed incentives to get GPs to work in deprived areas need to be looked at. "I have been concerned at the fact that in many deprived urban areas not only have we a shortage of GPs, there is also the ageing of GPs. I think the idea of a deprivation allowance or an allowance is something that should be examined in the context of the renegotiated contract [the GPs' medical card contracts] which is about to begin," she said.